Healthcare Provider Details

I. General information

NPI: 1164963005
Provider Name (Legal Business Name): AMY MARIE MORRIS NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/11/2017
Last Update Date: 09/19/2025
Certification Date: 09/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1040 SIERRA DR STE 1000
GREENWOOD IN
46143-0061
US

IV. Provider business mailing address

PO BOX 781076
DETROIT MI
48278-1076
US

V. Phone/Fax

Practice location:
  • Phone: 317-787-3276
  • Fax: 317-787-3043
Mailing address:
  • Phone: 317-528-4868
  • Fax: 317-865-8194

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number71008959A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number53-77588-012
License Number StateKS
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71008959A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: